Pulmonary anatomical segmentectomies have an acceptable morbidity rate. Postoperative complications are more likely to develop in male gender patients, with FEV1 ≤ 60% and operated by open surgery.

Fibrous dysplasia (FD) is a sporadic benign skeletal disorder that can affect one bone (monostotic form) or multiple bones (polyostotic bone). Around 6-20% of monostotic FD occurs in the ribs. The objective of this study was to report our experience in the management of the monostotic FD of the ribs. Between January 2004 and December 2009, seven cases of FD of the rib (six men and one woman, mean age 30.4 years, range 17-40 years) were operated on. The patients were evaluated with plain radiographs and computer tomography (CT). All our patients were symptomatic; two patients presented chest pain and swelling and other patients presented only chest pain. One rib was involved in all our patients (monostotic form): the site was fifth rib (four cases), sixth rib (two cases) or second rib (one case). Radiologically, plain films and CT showed an expansible lesion with a ground-glass centre and thinning of the cortex. Rib resection was performed in all patients; there were no postoperative complications and no recurrence in all cases at mean 43 month follow-up. In symptomatic monostotic FD of ribs, the involved segment of bone may be excised to rule out malignancy and for painful lesions.

Lipoma is a common benign tumor of soft tissues in adults. An intrathoracic location, particularly in the parietal pleura, is rare. We report two cases of pleural parietal lipoma with a review of literature. A preoperative diagnosis was established histologically by fine-needle aspiration in the first case and radiologically by computed tomography scan in the second. Both patients underwent surgical excision via thoracotomy and video-assisted thoracic surgery. Pathology examination confirmed the diagnosis of lipoma. The authors emphasize the necessity of surgical resection because of preoperative diagnostic difficulty of discerning lipoma from well-differentiated liposarcoma.

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The objective of the study was to report our experience in the management of hydatid cyst of the rib. Between December 2001 and December 2009, five patients underwent surgery for costal echinococcosis, among 234 cases of thoracic hydatid cyst managed in our department. They were three males and two females, aged 19-42 years (mean = 32.2 years). Imaging investigations consisted of chest X-ray and computed tomography. All the patients underwent thoracotomy along the arch of the infected rib. Albendazole was administered postoperatively in all cases. The echinococcosis of the rib was primary in 3 cases, and secondary to thoracic localization in 2 cases. It was located on the right side in four patients, on the left one in one patient. The posterior arch was the site of infection in 3 cases, and the anterior arch in 2 cases. The cyst was intact in 4 cases, and the invasion of adjacent structures was found in one case. There were no concomitant hydatid lesions. The resection of the infected rib was total in 2 cases and partial in 3 cases. There was no postoperative mortality or complications. The follow-up ranged from 28 months to 8 years did not show any recurrence. Echinococcosis of the rib is very rare. To avoid complications and to allow the eradication of the disease, the combination of surgery and antihelmentic drugs remains the best therapeutic choice.

Hydatid cysts of the lung should be treated before complications. Parenchyma saving is the best procedures for this benign disease; the radical resection must be reserved only for pulmonary destruction.

Congenital bronchial atresia (CBA) is a rare congenital malformation consisting in an interruption of a lobar or-more frequently-of a segmental bronchus. It leads to mucus impaction and hyperinflation of the obstructed lung segment. It causes infectious complications and, in the long term, destruction of the adjacent lung parenchyma. Thus, a surgical resection is usually indicated, even in asymptomatic patients.

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